- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,735.60 / $23,187.90 / $40,804.00
| Facility | | $13,735.60 | $23,187.90 | $40,804.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,728.18 / $20,728.18 / $20,728.18
| Facility | | $20,728.18 | $20,728.18 | $20,728.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,025.90 / $17,895.62 / $29,195.83
| Facility | | $12,025.90 | $17,895.62 | $29,195.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,494.65 / $21,035.91 / $29,367.42
| Facility | | $12,494.65 | $21,035.91 | $29,367.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,474.00 / $45,474.00 / $53,367.60
| Facility | | $45,474.00 | $45,474.00 | $53,367.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $19,798.81 / $28,864.90
| Facility | | $1,787.00 | $19,798.81 | $28,864.90 |